He had low
thyroid hormone levels, inflammation of his esophagus and fever
of unknown origin. His loss of vision was so profound he was
almost blind, and his loss of hearing so severe he was almost
deaf. Most perilous of all, his heart had weakened so much it
could not pump hard enough to supply blood to his body.

In a paper just published in the journal The Lancet, the Marburg doctors note that
"his medical history was mostly uneventful, apart from the fact
that he had had both hips replaced."

This observation would prove crucial, as would the doctors' media
consumption.

The medical team was familiar with the TV show House, in which
Hugh Laurie plays a Sherlock-type title character — a master of
solving medical mysteries. (They have even used the show for
teaching, they said.)

In unraveling the patient's strange web of symptoms, the German
doctors remembered one episode in which the fake patient (played by
Candice Bergen) had been poisoned by cobalt used in her hip
replacement.

On a
House-related hunch, the real-life doctors measured their
patient's cobalt level. "It was a thousand times the level
considered normal," Kolatareports.

What had happened? The man had had a ceramic hip before his metal
one, and a doctor had left behind bits of ceramic that rubbed
against the new metal joint.

Here you can see a visible hole in the metal prosthetic they
removed from the man:

After the
patient received a new ceramic hip and an implanted
defibrillator, the poisoning subsided, his fever and esophageal
problems went away, and his heart improved. Sadly, he did not
significantly regain his vision or hearing.

Cobalt poisoning from hip replacements is not common, even with
metal-on-metal artificial hips.

"The stability of cobalt" — when combined with other components
used in artificial hips — "made this metal an excellent and
stable compound in hip prosthetics," The Lancet
doctors write.

"Literally tens of thousands of people had these hips without
[such] problems," Larry A. Allen of the University of Colorado
told The Times.

But when metal
hips are placed incorrectly by surgeons or combined with ceramic
hips, cobalt poisoning is a small risk. It's "an increasingly
recognised and life-threatening problem," the Lancet paperconcludes.